Arthroscopy was invented by the Japanese doctor from the University of Tokyo, K. Takayi (1918), using a cystoscope with which he observed the inside of the knee. The first arthroscopic examination was carried out in a cadaver knee in Japan in 1938. Doctor M. Watanabe subsequently succeeded Doctor K. Takayi and persisted in his labor for developing the arthroscopic technique whereby in 1960, in collaboration with Dr. S. Takeda, he presented the arthroscope 21, designed for the arthroscopy of the knee joint. In 1962 Doctor Watanabe was the first to carry out a meniscectomy of the PHMM (posterior horn of the medial meniscus) by arthroscopy.
In 1966, Doctor R. W. Jakson removed two free bodies from the knee and in 1970, a bucket handle using the arthroscopic technique. Doctor R. W. Jakson traveled to Japan, and surprised and fascinated by the viewing of the knee joint carried out by Watanabe, on his return to Toronto he developed arthroscopy and positively influenced the establishment of said technique in the Western world. Doctor R. W. Jakson was thus the person responsible for this progress, although many authors had an influence in the imposition of arthroscopy in the 70s such as: Dandy, 1978; Carson, 1979; Eikelara, 1975; Ikeuchi, 1979; OR'Connor, 1979 or Guillen, 1979.
In the 70s, in first generation arthroscopy, the inside of a joint was viewed with direct viewing through a lens which was fed with a cold-light source and cable. There were teaching optics for taking photographs and for the collaborator to look at the surgeon who is operating at that time.
In the 80s, second generation arthroscopy was developed and arthroscopic cameras appeared which displayed the image of the inside of the joint on a screen, after being perfectly adapted to the lens. This second step in arthroscopy requires two cables crossing the surgical field and requiring disinfection because they are contamination and infection sources. The lens, through a connection with the cable to the light source, receives the illumination which it transfers to the joint, which is full of serum and is thus made visible. The illumination system comprises a light source, generally xenon or tungsten, with an adjustable intensity according to the articular tissue which is to be focused on, and a glass fiber cable connected to the arthroscope. Said cable, with a length of about two meters, crosses the entire operating field, becoming a contamination source, causing post-arthroscopic septic arthritis. Said cable must therefore be sterilized prior to any operation. The deterioration of the glass fibers further negatively affects the desirable aseptic conditions which must be maintained in the operating room.
The inside of the joint is visually inspected with the lens illuminating the joint which is full of serum. After the direct viewing, a lens articulated with a photographic camera is applied to obtain photos. This methodology is known as diagnostic arthroscopy.
The camera applied to the lens and connected by a long cable with an extension of two to three meters, sterilized or in a sterile cover, to a monitor has formed a great advance in second generation arthroscopy. Operations are thus recorded or photographed, facilitating the knowledge and teaching of advanced surgical procedures.
However, the second generation arthroscopic techniques that are currently used have obligations which are responsible for most of the articular infections that the patient suffers from when he or she is subjected to an operation in which said arthroscopic techniques are used. A review of the medical literature from 1988 to 2005 was carried out in the present invention. Said study shows different percentages of infection in arthroscopic surgery which vary from 0.4 to 2.0%, this figure being greater in the shoulder than in the knee. This percentage of infection decreases when arthroscopies are carried out using the apparatus of the invention.
The present invention therefore relates to an apparatus or system (hereinafter apparatus of the invention) for carrying out arthroscopies which does not comprise cables or a connection joining it to the arthroscopy tower, preventing the articular infections caused by said cables and referred to previously. The present invention therefore forms the step from second generation arthroscopy (comprising arthroscopic cameras taking images of the inside of the joint and showing them on a screen after being perfectly adapted to the lens, requiring two cables crossing the surgical field and requiring being disinfected since they are contamination and infection sources) to third generation arthroscopy, which is the object of the present invention and enables carrying out arthroscopies without cold-light cables, decreasing the risk of patients suffering from articular infections.
On the other hand, apart from providing the surgeon with the possibility of carrying out risk-free arthroscopies or arthroscopies with a lower risk of articular infection and therefore enabling the patient to undergo an operation with a lower risk of infection, the apparatus of the invention, due to the fact that it does not comprise cables, is a surgical tool which can be used by the arthroscopist more independently than those existing in the state of the art, which comprise cables.
Since it does not comprise cables or connection, the apparatus of the invention, further involves a simplification of the system used in the state of the art, which fact provides it with the possibility of being used in medical offices, without requiring the complex installations (generally in operating rooms with stricter and more expensive asepsis and sterility conditions) associated to current arthroscopy systems. The possibility of being used without having to use complex installations has the advantage that the economic cost associated to said use of the service is reduced.
The portability of the system of the invention, which makes it more suitable for ambulatory diagnosis and surgery in places far from the large hospital centers, is also emphasized.